Provider Demographics
NPI:1386036697
Name:REJI, IRIN MARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:IRIN
Middle Name:MARY
Last Name:REJI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 SW 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8735
Mailing Address - Country:US
Mailing Address - Phone:209-331-6116
Mailing Address - Fax:
Practice Address - Street 1:8905 SW 78TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8735
Practice Address - Country:US
Practice Address - Phone:209-331-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist